Arterial stiffness and endothelial dysfunction in HIV-infected children

Area of Science:

• Pediatric Cardiology
• Vascular Biology
• Infectious Diseases

Background:

• The link between antiretroviral therapy (ART) and atherosclerosis acceleration in HIV-infected adults is debated due to confounding cardiovascular risk factors.
• Vascular function in HIV-infected children requires further investigation.

Purpose of the Study:

• To assess vascular function in children living with HIV.
• To investigate potential differences in vascular function between treated and untreated HIV-infected children.
• To explore the impact of dyslipidemia on vascular parameters in this population.

Main Methods:

• A cross-sectional study involving 49 HIV-infected children (34 on ART, 15 treatment-naïve) and 24 age/sex-matched controls.
• Utilized automated, computerized ultrasound to evaluate common carotid artery geometry, mechanics, and endothelial-dependent/independent dilation.
• Analyzed intima-media thickness, cross-sectional compliance, distensibility, and wall stiffness (incremental elastic modulus).

Main Results:

• HIV-infected children displayed significantly lower carotid artery diameter variations, cross-sectional compliance, and distensibility compared to controls.
• Increased arterial wall stiffness was observed in HIV-infected children.
• Endothelium-dependent dilation was impaired, while non-endothelium-dependent dilation was similar between groups.
• No significant differences in vascular variables were found between ART-treated and treatment-naïve HIV-infected children, or between those with and without dyslipidemia.

Conclusions:

• HIV-infected children experience vascular dysfunction independent of traditional cardiovascular risk factors.
• In this cohort, approximately 5 years of ART did not appear to exacerbate vascular dysfunction.